The authors prospectively studied the feasibility and safety of high-dose dipyridamole echocardiography in 166 patients (77 younger and 89 elderly patients) referred for clinical evaluation of coronary artery disease. Echocardiographic examinations were adequate for analysis of parameters considered in 135 of the 166 patients (81.3%; 73 elderly, 62 younger patients). The feasibility of dipyridamole echocardiography test was 80.5% in young and 82% in elderly patients (P = ns). The incidence of side effects during dipyridamole echocardiography was similar in the two groups, except for dyspnea, which was observed in 20.5% of older and 3.2% of younger patients (p < 0.05). These data demonstrate that the dipyridamole test combined with echocardiographic monitoring of regional myocardial contractility may be considered a valid noninvasive method of evaluating coronary artery disease in the elderly.